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Jeanenne Hatletvedt is happy she ended up on the right side of a medical irony.

She is 75 years old. She suffers from pneumonia and non-Hodgkins lymphoma, has had chemotherapy three times in seven years, had her spleen removed and was spending day and night on a breathing machine. She also has back pain from arthritis.

Her troubles made her too weak for the open-heart surgery she needed to correct another problem, a severe narrowing of the aortic valve.

So, she went to plan B, something called a transcatheter aortic valve replacement, or TAVR. It’s a procedure the government recently endorsed but only as a last resort for patients with too many other problems for conventional surgery.

Her surgery was in September at the Sanford Heart Hospital in Sioux Falls. Physicians ran a narrow tube called a catheter through her bloodstream from her thigh to the heart and used that passageway to place an artificial valve at the trouble spot, where the aorta connects to the left ventricle.

“The day after the surgery, the first thing I noticed was that I could breathe,” she said.

To her, that was a happy and surprise ending.

Because she was too sick for the standard procedure, she became eligible for a remedy that was easier on her body.

Instead of physicians cutting open her chest, they repaired her heart with tiny equipment they ran through a 3-foot tube from a small leg wound.

“I can’t believe it myself,” Hatletvedt said.

Catheters are a common tool, allowing doctors to enter a patient’s body at one point and use the bloodstream as a highway system to reach another area needing care. A physician often uses a catheter to position a stent, a tiny device resembling a piece of straight macaroni, where it can prop open a plugged artery to improve blood flow.

But it was only this year that the U.S. Food and Drug Administration approved TAVR for the heart. Sanford doctors used the procedure four times in Sioux Falls last month, on patients ranging from their mid-60s to age 92. They’ve used it for another seven patients in Fargo.

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The key piece of equipment is the Edwards Sapien transcatheter heart valve. It is a collapsible, mesh-like circular piece of metal that is as slender as a paper clip. Doctors use a wire inside the catheter to pull the artificial valve into place. Following their progress on an electronic screen, they take it from the opening at the leg, up past the abdomen and through the arch above the heart and then back down a few inches to reach the ventricle.

It’s there that a healthy body has a fleshy valve that opens and closes as the heart pushes blood from the ventricle into the aorta on its way to the brain, chest and other points.

The valve normally provides an opening the size of a quarter. Hatletvedt’s was smaller than a dime. She had aortic valve stenosis, a condition causing dizziness and fatigue that turns small tasks such as walking across the room into a major chore.

“This is not a subtle disease,” said Dr. Tom Stys, an interventional cardiologist at Sanford. “But too many people don’t ask for help. When it occurs, there’s about a 50 percent likelihood of dying the next 12 months.”

Stys is part of a team of specialists that use the new procedure at Sanford. After they route the Edwards valve through the catheter over the arch to reach the ventricle, they come to a key moment of about 10 seconds where they appear to stop the heart. The heart does not actually stop. But doctors use a pacemaker to ramp it up to 200 beats a minute, a fluttering pulse so fast that it appears to stop while providing a brief window to position the valve and use a balloon to open it and lock it in place.

A lot has to happen right in that 10 seconds.

“It’s like keeping 10 balls in the air,” said Dr. Verlyn Nykamp, a Sanford surgeon.

The valve costs $32,000 and the procedure more than $100,000. Nykamp said in the end that can be cheaper and result in a higher quality of life than a regime for congestive heart failure requiring a half-dozen trips to the hospital. Its ease on the body might lead the government to approve its wider use. So far, it’s only for patients with complications such as age, scars from previous surgery or lung disease that would keep them off a bypass machine.

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“Overall, it’s frailty, patients who don’t have the stamina to recover from an operation,” Nykamp said.

Hatletvedt lives in southwest Minnesota. She lived on a farm 55 years, was a nurse 42 years in Canby and Clarkfield and recently moved to Porter, a town of 180 people. She lost her husband, David, to a heart attack in 1986, when he was 48, and lost her son, Harold, in a traffic accident three years later. Her problems began to add up, including cancer and pneumonia that returned whenever she caught cold.

“I persevered. I’m a fighter,” she said.

A recurrence of pneumonia in January led to intensive care and meeting Stys, who said her aortic valve was collapsing and that traditional surgery wouldn’t work. That began the wait to gain clearance on the alternative procedure, multiple phone calls with Sanford and more delays.

“All my friends and neighbors and pastor and my son and his wife were waiting and waiting and wondering what was going on. They kept moving it back,” she said. When the call she wanted finally came, “by next morning, everybody in Porter knew about it.”

She said she understands the reasons for delay and is confident Medicare is picking up the tab.